1.The subclavian vein is accessed and a pulse generator pocket is formed.2.Under fluoroscopy, the pacing lead(s) are inserted into the right atrium (33206) or right ventricle (33207) for a single chamber system, or into the right atrium and right ventricle for a dual chamber system (33208).3.Lead measurement tests, including pacing and sensing thresholds and lead impedances, are performed.4.The pacemaker pulse generator (included in 33206, 33207, and 33208) is connected to the lead(s) thatare in place.

PACEMAKER 2012 Billing and Coding Guide

Commonly Billed Pacemaker Scenarios

Key:Moderate sedation (For these procedures, moderate [conscious] sedation is included and cannot be billed separately when provided by the same physician. See AMA’s 2012 Current Procedural Terminology for specific guidelines.)

+ Add-on code

Physician CPT® Codes1

Hospital Outpatient CPT® Codes2

Hospital Inpatient ICD-9-CM Codes3

1.1 Initial single chamber rate-responsive pacemaker system implant with right atrial lead

Scenario 1.1: Physician CPT® Codes1

33206Insertion of new or replacement of permanent pacemaker with transvenous

electrode(s); atrial

Scenario 1.1: Hospital Outpatient CPT® Codes2

33206Insertion of new or replacement of permanent pacemaker with transvenous

electrode(s); atrial

Scenario 1.1: Hospital Inpatient ICD-9-CM Codes3

37.73 Initial insertion of transvenous lead [electrode] into atrium

Excludes:

• Insertion of temporary transvenous pacemaker system (37.78)

• Replacement of atrial and/or ventricular lead(s) (37.76)

37.82Initial insertion of single chamber device, rate responsive

• Rate responsive to physiologic stimuli other than atrial rate

Excludes:

• Replacement of existing pacemaker device (37.85–37.87)

1.2 Initial single chamber rate-responsive pacemaker system implant with right ventricular

lead

Scenario 1.2: Physician CPT® Codes1

33207Insertion of new or replacement of permanent pacemaker with transvenous

electrode(s); ventricular

Scenario 1.2: Hospital Outpatient CPT® Codes2

33207Insertion of new or replacement of permanent pacemaker with transvenous